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Full text of "COSTA RICA. Reports from Port Limon—Fruit port"

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August 30,1901 2002 

last year and this year have not all been confined to the same building, 
or even to the same neighborhood ; nor can I say that an epidemic of 
the disease has existed. There are many people who deny the existence 
of the disease (this includes some of the native practitioners of medi- 
cine); therefore, I am led to believe that cases have existed and not 
been reported. 

Most of the cases seen by me were protected by mosquito netting, but 
during the day, owing to the heat and oppression, they said that they 
had to have the netting raised, preferring to have a few bites of the 
mosquito rather than to be denied the comfort they felt by removing 
the net. 

The first ease of yellow fever that came under my observation in 1900, 
July 15, was several hundred yards from my residence ; the next person 
attacked was my wife, on July 18, 1900. I cared for her and no doubt 
was bitten by mosquitoes, but did not become ill until August 16, 1900. 

The premises were thoroughly disinfected under the direction of 
Dr. Allen Jumel, Jr., medical representative Louisiana State board of 
health. In the latter part of October, Dr. W. A. Blackburn (dentist) 
and wife came into our house to stay, and his wife was taken ill with 
yellow fever November 3. He cared for his wife during the time, and 
I am sure that he was bitten by the mosquitoes, and until the present 
time has not been ill with yellow fever. 

During the present year there were no known cases of the disease 
from the early part of February until June 23. The case that occurred 
on the latter date was in the hospital of the United Fruit Company, and 
I am sure that all the beds were not furnished with nets ; in this case it 
would be hard to tell whether the subsequent cases that occurred in the 
town in individuals who had visited the institution (distant 2J miles), 
were from contact or from inoculation by the mosquitoes. 

Another case that I observed (Mrs> Bead), was attended by her hus- 
band, as a nurse was not obtainable, was taken ill about July 4, was 
very much annoyed by mosquitoes, and no doubt both of them were 
bitten during her illness ; to the present time the husband has shown 
no symptoms of the disease ; however, he tells me that he suffered a 
severe malaise for about three days during her sickness. He did not 
mention it to me at the time. 

Under the present conditions I find it very difficult to arrive at any 
definite conclusions, or to make any satisfactory investigations. 
Bespectfully, Faux Osterhotjt, 

Acting Assistant Surgeon, U. 8. M. H. 8. 

The Surgeon General, 

U. S. Marine- Hospital Service. 

OOSTA RIGA. 

Reports from Port Limon — Fruit port. 

Port Limon, Costa Eica, August 10, 1901. 

Sir : I have to make the following report of the conditions and trans- 
actions at this port during the week ended August 10, 1901 : 

Present estimated population, 4, 000. Number of cases and deaths from 
yellow fever during the week, cases, 4 ; deaths, 2 ; number of cases and 
deaths from smallpox during the week, none ; number of cases and deaths 
from typhus fever during the week, none ; number of cases and deaths 
from cholera during the week, none ; number of cases and deaths from 
plague during the week, none ; number of deaths from other causes dur- 



QAAO August 30, 1901 

ing the week, 4. Prevailing diseases, malarial fever in its various forms 
and yellow fever. General sanitary condition of this port and the sur- 
rounding country during the week* not good. Since August 1 8 cases 
and 3 deaths have been reported. 

Bills of health were issued to the following vessels : August 5, steam- 
ship Alene ; crew, 38 ; passengers from this port, 3 ; passengers in transit, 
5; pieces of baggage disinfected, none. August 7, steamship Kitty; 
crew, 20 ; passengers from this port, none ; passengers in transit, none ; 
pieces of baggage disinfected, none. August 8, steamship Olympia; 
crew, 38 ; passengers from this port, none ; passengers in transit, none ; 
pieces of baggage disinfected, none. August 9, steamship Hispania; 
crew, 22 ; passengers from this port, none ; passengers in transit, none ; 
pieces of baggage disinfected, none. August 10, steamship Alabama; 
crew, 18 ; passengers from this port, none ; passengers in transit, none ; 
pieces of baggage disinfected, none. 

Eespectfully, D. W. Goodman, 

Acting Assistant Surgeon, 77. 8. M. H. 8. 

The Surgeon-General, 

77. 8. Marine- Hospital Service. 

The mosquito and yellow fever — The use of mosquito bars. 

Port Limon, Costa Eica, August 15, 1901. 

Sir : Eeplying to Bureau letter of August 2 (McB.), asking for infor- 
mation as to the use of mosquito netting in houses in which were yellow - 
fever patients, I have to say the occupants of the 2 houses reported 
on were not in the habit of using the netting, mosquitoes being very 
troublesome for only a few hours in the early part of the night, and 
again after daylight— that is, only in the interim between the land and 
sea breezes. I have urged the use of the netting in my conversations 
with nonimmunes since my arrival here, and I think with good results. 

Some weeks ag6 Dr. Steggall, who has charge of the hospitals of the 
Costa Eican Eailroad and of the United Fruit Company, consulted with 
me on this subject. We agreed on a plan, which has been carried out 
as follows : The upper story of 1 section of the hospital of the United 
Fruit Company, has been reserved exclusively for yellow-fever patients, 
permission having been obtained to take all private patients there, as 
soon as a diagnosis was made or suspected. These wards are shut off from 
the other portion of the hospital, and every window and door opening 
is supplied with a frame covered with netting. This is better than indi- 
vidual mosquito bars. The result has been satisfactory. At the Charity 
or City Hospital, however, no such good conditions exist, for while the 
city physician, Dr. Aguila, is fully alive to the situation and its needs, 
he claims the Government gives him no funds or means to carry out 
these measures, and it is in this hospital that most of the deaths have 
occurred. 

I have received several copies of Department Circular No. 71, and 
will give one to each of the local physicians in Port Limon. 

Since writing the above I have learned that the governor has placed 

at the disposal of the city physician, funds sufficient to put mosquito 

netting at the doors and windows of the Charity Hospital, and to make 

other improvements necessary for the comfort and safety of its occupants. 

Eespectfully, D. W. Goodman, 

Acting Assistant Stirgeon, 77. S. M. if- S. 

The Surgeon-General, 

77. 8. Marine- Hospital Service. 
152